Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States. Most sexually active people will contract HPV at some point in their lifetime. More than 100 types of HPV exist, and more than 40 subtypes of HPV can affect the genital area and throat. HPV spreads by skin-to-skin contact.
Most people contract HPV in their genital area through sexual intercourse. If you engage in oral sex, you may contract it in your mouth or throat. This is most commonly known as oral HPV.
Oral HPV often has no symptoms. This means that people don’t realize they’re infected and are less likely to take the steps necessary to limit the spread of the disease. It’s possible to develop warts in the mouth or throat in certain cases, but this is less common.
This type of HPV can turn into oropharyngeal cancer. If you have oropharyngeal cancer, cancer cells form in the middle of the throat, including the tongue, tonsils, and pharynx walls. These cells can develop from oral HPV. Early symptoms of oropharyngeal cancer include:
- trouble swallowing
- constant earaches
- coughing up blood
- unexplained weight loss
- enlarged lymph nodes
- constant sore throats
- lumps on the cheeks
- growths or lumps on the neck
If you notice any of these symptoms and you know or think you may have HPV, make an appointment with your doctor immediately.
Oral HPV occurs when a virus enters the body, usually through a cut or small tear inside of the mouth. People often get it through having oral sex. More research is necessary to determine exactly how people get and pass on oral HPV infections. Researchers have only done a few studies to find out how people get HPV, and the results are often conflicting.
Approximately 79 million Americans currently have HPV, and 14 million people will be newly diagnosed this year alone. Approximately 7 percent of Americans ages 14 to 69 have oral HPV. The number of people who have oral HPV has increased over the past three decades. It’s more common in men than in women.
Approximately two-thirds of oropharyngeal cancers have HPV DNA in them. The most frequent subtype of oral HPV is HPV-16. HPV-16 is considered a high-risk type. Oropharyngeal cancer is rare. Approximately 1 percent of people have HPV-16. Less than 15,000 people get HPV-positive oropharyngeal cancers each year.
Risk factors for oral HPV include the following:
- Oral sexual activity is a risk factor, especially if you have multiple sexual partners. If you’ve had had 20 or more sexual partners, your chances of getting an oral HPV infection may be as high as 20 percent.
- Smoking is a risk factor. Inhaling hot smoke makes you more vulnerable to tears and cuts in the mouth.
- Drinking alcohol is a risk factor. You’re at an even higher risk if you’re both a smoker and drinker.
- Open mouth kissing is a risk factor, but more research is necessary to determine if this increases your risk for oral HPV.
- Men have a greater risk of receiving an oral HPV diagnosis than women.
Age is a risk factor for oropharyngeal cancer. It’s more common in older adults because it takes years to develop.
No test is available to determine if you have HPV of the mouth. Your dentist or doctor may discover lesions through a cancer screening, or you may notice the lesions first and make an appointment.
If you have lesions, your doctor can perform a biopsy to see if the lesions are cancerous. They’ll probably also test the biopsy samples for HPV. If HPV is present, the cancer may be more responsive to treatment.
Most types of oral HPV go away before they cause any health issues. If you develop oral warts due to HPV, your doctor will likely remove the warts. Treating the warts with topical treatments can be difficult because the warts may be hard to reach. Your doctor may use any of the following methods to treat the warts:
- surgical removal
- cryotherapy, which is where the doctor freezes the warts
- interferon alfa-2B (Intron A, Roferon-A), which is an injection
If you do develop oropharyngeal cancer, treatment options are available. Your treatment and prognosis depend on the stage and location of your cancer and whether or not it’s associated with HPV. HPV-positive oropharyngeal cancers have better outcomes and fewer relapses after treatment than HPV-negative cancers. Treatment for oropharyngeal cancer can include radiation therapy, surgery, chemotherapy, or a combination of these.
Most medical and dental organizations don’t recommend screening for oral HPV. Lifestyle changes are some of the easiest ways to help prevent HPV. Here are some tips for prevention:
- Limit your sexual partners.
- Ask your sexual partners if they’ve recently been tested for STIs.
- If you’re with an unfamiliar partner, avoid oral sex.
- Use a condom any time you have sexual intercourse.
- In your six-month checkups at the dentist, ask them to search your mouth for anything abnormal, especially if you have oral sex often.
- Make it a habit to search your mouth for any abnormalities once per month.
- When having oral sex, use dental dams or condoms.
Vaccination against HPV involves getting three shots over six months. You’ll need to get all three shots for the vaccine to be effective. These vaccines don’t prevent oropharyngeal cancers linked to HPV, but it’s always best to protect yourself.